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CMBM exam 2 > Antibiotics 1 & 2 > Flashcards

Antibiotics 1 & 2 Flashcards

1
Q

Bacteria groups: Aerobic gram-positives

A

Staph
Streptococcus
Enterococci
Listeria

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2
Q

Bacteria groups: Aerobic or facultative gram negatives

A

Enterobacteriacease
Neisseria
Peudomonas
Haemophilus

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3
Q

Bacteria groups: Anaerobes

A 
Clostridum
Actinomyces
Peptostreptococcus 
Bacteroids
Fusobacterium
Prevotella
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4
Q

Bacteria groups: Atypical/intracellular

A 
Mycoplasma
Chlamydia
Legionella
Mycobacterium
Rickettsia
Spircochetes
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5
Q

What bacteriocidals target cell walls?

A

B-lactams
Vancomycin
Daptomycin (cell membrane)

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6
Q

What bacteriostatics inhibit growth or replication (RNA synth)?

A

Rifamycin

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7
Q

What antibiotics block protein synthesis?

A

Aminoglycans
Macrolides
Tetracyclins

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8
Q

What antibiotics target DNA or DNA synth?

A

Quinolones

Metronidazole

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9
Q

What is the anti-metabolite antibiotics?

A

Trimethoprim-sulfamethoxazole

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10
Q

What are some B-lactams that works on gram positives and some gram negatives?

A

Penicillins
Cephalosporins
Carbapenems
Monobactams

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11
Q

What cell wall inhibiting antibiotics are good from gram positives?

A

Vancomycin

Daptomycin

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12
Q

What cell wall inhibiting antibiotics are good for TB?

A

Isoniazid
Ethambutol
Pyrazinaminde

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13
Q

What is the mechanism of action for B-lactams?

A

They bind to transpeptidases (PBPs) (which catalyse cross linking of peptidoglycan residues) and block the reaction resulting in weak cell walls

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14
Q

What kinds of bacteria are natural penicillins active against?

A

Streptococcal species (GAS, GBS, viridans)
Most gram-positive anaerobes
Treponema pallidum

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15
Q

What strep group is resistant to natural penicillin?

A

S. pneomoniae

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16
Q

What is the action of anti-staph penicillin?

A

They have large R-groups which make them resistant to staph b-lactamases

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17
Q

What are some types of anti-staph penicillins?

A

Nafcilllin, Oxacillin, Dicloxacillin

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18
Q

What are anti-staph penicillins active against?

A

MSSA - methicillin sensitive staph aureus

MSSE - methicillin sensitive staph epidermidis

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19
Q

What are the 2 types of aminopenicillians?

A

Ampicillin and Amoxicillian

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20
Q

What does the addition of an amino group to an R chain make aminopenicillins effective against gram-negatives?

A

Allows for penetration through porins (especially rods)

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21
Q

Aminopenicillins are effective against many of the same things as natural plus:

A

E. coli, shigella, salmonella burgdorfi

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22
Q

What antibiotics are included in the extended spectrum penicillins?

A

Piperacillin, ticarcillin, carbenicillin

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23
Q

What can extended spectrum do better than aminopenicillin?

A

It can better penetrate gram-negative porins

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24
Q

Extend spectrum penicillins are effective against many of the same things as natural plus:

A

More enterobacteriaceae and some strains of p. aeruginosa

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25
Q

What is a beta-lactamase?

A

Enzymes with specific activity against beta-lactams

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26
Q

What combination can be used as a beta-lactamase inhibitors?

A

Aminopenicillin and extend spectrum

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27
Q

How does a b-lactamase inhibitor work?

A

The b-lactam ring acts as a decoy for the lactamases and then IT STRIKES

28
Q

What bacteria have b-lactamases?

A

S. aureus, H. influenzae, N, gonorrhoeae, many enterobacteriaceae, certain anaerobes

29
Q

What antibiotics are b-lactamase inhibitors?

A

Clavulanic acid
Sulbactam
Tazobactam

30
Q

What are some B-lactamases combined with aminopenicillins?

A

Amoxicillin + Clavulanate = Augmentin

Ampicillin + Sulbactam = Unasyn

31
Q

What are some B-lactamases combined with extended spectrum penicillins?

A

Piperacillin + tazobactam = Zosyn

Ticarcilllin + Clavulanate = Timentin

32
Q

What are some of the problems with the toxins related to penicillins?

A

Hypersensitivity, can activate a hapten becoming immunogenic after binding to RBC

33
Q

What signs occur with a type 1 hypersensitivity to penicillin?

A

Skin rashes and anaphylaxis

34
Q

What signs occur with a type 2 hypersensitivity to penicillin?

A

Drug-induced hemolytic anemia

35
Q

What are some characteristics of Cephalosporins and Cephamycins?

A

More resistant to b-lactamases than natural penicillins
Wider spectum of activity that naturals
Generational
Not particularly useful against anaerobes or intracellular organisms

36
Q

What are the first generation Cephalosporins and Cephamycins?

A

Cefazolin and cephalexin

37
Q

What is the second generation Cephalosporins and Cephamycins?

A

Cefuroxime

38
Q

What is the third generation Cephalosporins and Cephamycins?

A

Ceftriaxone

39
Q

What is the fourth generation Cephalosporins and Cephamycins?

A

Cefepime

40
Q

What in the “generalization” about Cephalosporins and Cephamycins?

A

With increaseing generation activity in vitro against aerobic gram-positives decreases while activity against gram-negatives increases

41
Q

What are the first generation Cephalosporins and Cephamycin used for?

A

They are similar to aminopenicillin and used for minor skin and soft tissue infections and UTIs

42
Q

What is the second generation Cephalosporins and Cephamycin used for?

A

Used against gram-positive spectrum plus acitivty agisnt E. coli, Klebsiella, Proteus, H. influenzae and Neisseria

43
Q

What is the third generation Cephalosporins and Cephamycin used for?

A

They are moderately active agisnt aerobic gram positives (MSSA) plus activity against aerobic gram negatives, with modified R chains and can cross through the blood-brain barrier

44
Q

What is the fourth generation Cephalosporins and Cephamycin used for?

A

Retains some third generation spectrum, activity against pseudomonas, inc affinity to PBP and can penetrate porins better, poor activity against anaerobes

45
Q

What are some types of Carbapemems?

A

Imipenem, meropenem, ertapenem

46
Q

How do carbapemems rank as a spectrum drug?

A

Among the most broad spectrum

47
Q

Compared to other b-lactams, Carbapemems;

A

Have improved penetration of porins, enhanced binding to PBP and inc resistance to b-lactamases

48
Q

What are some clinical uses of Carbapemems?

A

Useful against Pseudomonas

49
Q

What is special about Imipenem?

A

It was the “hail mary” of drugs and can be combined with cilastatin (called Primaxin) to inhibit renal dihydropeptidase

50
Q

What types of bacteria are Carbapenems effective against?

A

Many bacteria, broad spectrum, useful against Pseudomonas, resistant to B-lactamases

51
Q

What bacteria are Carbapenems not effective against?

A

MRSA, Clostridium difficile and Burkholdreia cepacia

52
Q

Which is the only licensed drug in the Monobactam group?

A

Aztreonam

53
Q

Because the R groups are attached directly to the B-lactam ring, what special ability does it have?

A

Ability to penetrate porins and bind to gram negative PBP

54
Q

What type of safety situations can Aztreonam be used for?

A

Used for patients with penicillin allergies and patients with renal disease

55
Q

Does Aztreonam have what type of spectrum of activity? And which bacteria are effected?

A 
Narrow
Moraxella
Neisseria
Enterobacteriaceae
Pseudomonas
Haemophilus
Burkholderia
56
Q

What are some of the adverse reactions to B-lactams?

A

Penicillin binding to proteins or RBCs to become immunogenic, rashes to anaphylaxis, hemolysis

57
Q

If someone has adverse reactions to penicillin should they be given cephalosporins?

A

NO

58
Q

If a person has a CNS disease what could happen if they were given a Carbapenem?

A

Seizures

59
Q

How could a bacteria be resistant to B-lactams?

A 
Penetrations (Intracellulars)
Porins 
Pumps (efflux)
Penicillinases (B-lactamases)
Penicillin-binding proteins 
Peptidoglycan (lack of)
60
Q

What does it mean when a bacteria is intrinsically resistant to an antibiotic?

A

The resistance is a constitutive part of the bacterial species - naturally resistant

61
Q

What is bacterial acquired resistance to a antibiotic?

A

Resistance formed by mutations, phage transduction and aquiring genes from another bacterial strain/species (transformation, conjugation)

62
Q

What are some altered cephalosporins and cephamycins and how are they modified?

A 
MRSA and Pneumococci (penicillin binding protein)
Pseudomas aeruginosa (efflux pump)
63
Q

What does Vancomycin inhibit cell walls?

A

Binds to the D-ala-D-ala building block of peptidoglycan

64
Q

With a narrow spectrum of activity, what does Vancomycin work against?

A

MRSA, penicillin resistant S. pneumo and certain enterococcal infections

65
Q

How does enterococci make itself resistant to Vancomycin?

A

Changes the D-ala-D-ala to D-ala-D-lac

66
Q

When should you use Daptomycin?

A

For aerbic gram-positives

MRSA, penicillin resistant S. pneumo and vancomycin resistant enterococci

67
Q

What does Daptomycin not effective against?

A

Gram negative bacteria

CMBM exam 2 (13 decks)

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